It's because of bureaucratic nightmares.  After you fill out your paperwork, or have to higher a company to fill out your paperwork--because Medicaid rejects claims for things like, oh, the wrong ink being used on the form--  you get to sit back and wait forever while they find any possible excuse to deny your claim.

These guys can't afford it.  I know of one that was dipping into his savings to meet payroll until he hopefully some day got paid, and another that had to cut off patients because the state owed him something like 100k and dragged their feet for almost nine months and counting to pay it.

We spend 4.5 billion or so on Medicaid, and where does the money go? Not much goes to the doctors.  

The system needs to be changed.  I'm quite sure that many docs would accept patients, if they knew that  they would be reimbursed, with little hassle, even at a lower rate than they could charge someone else.

Let's say a medical savings account, tied to a bridge card.  The state and the Docs decided on reimbursement rates for individual procedures (and won't that be fun!) and they get taken off the card.  No waiting, no hassle, no 27 forms in triplicate to fill out, or calling some bureaucrat who won't answer his phone because he can't find it because there are 8000 claims sitting on his desk,  that he hasn't gotten to yet.... cut out the middle man.

Have the traditional system kick in only for "catastrophic" medical issues.

Too many people focus on the legislature and the governor as the focus of the problems in this state, and on that they get partial credit.

The problem with this state isn't the Capitol, it's all those buildings behind the Capitol.